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Opinion: Medical Aid in Dying and the Burden of Choosing to Live

by Monika Piotrowska

Published 2026-08-26 08:30:00+00:00

If a doctor can help you die, does staying alive become a choice you have to justify?

0:00 / 5:56 · Narrator Vindemiatrix

Context

New York recently allowed terminally ill patients to request life-ending medication. Advocates treat the extra option as a clear win for personal freedom. But an essay published on 26 August 2026 pauses on a heavier problem. Once a doctor officially presents death as a medical option, staying alive stops being the default. Living suddenly becomes a choice that requires a reason. The question then is what happens to a patient when simply existing turns into a decision they have to actively justify.

Show notes

An examination of the psychological burden created when medical aid in dying becomes a legal option. Drawing on philosopher David Velleman, the argument shows how offering death as a medical treatment changes living from a default state into a choice that requires justification. This creates a practical tension between ensuring patients have access to end-of-life care and forcing them to actively decide whether to keep living.

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